Social norms related to fertility may be driving pregnancy desire, timing and contraceptive use, but measurement has lagged. We validated a 10-item injunctive Fertility Norms Scale (FNS) and examined its associations with family planning outcomes among 1021 women and 1020 men in India. FNS captured expectations around pronatalism, childbearing early in marriage and community pressure. We assessed reliability and construct validity through Cronbach's alpha and exploratory factor analysis (EFA) respectively, examining associations with childbearing intention and contraceptive use. FNS demonstrated good reliability (α = 0.65–0.71) and differing sub-constructs by gender. High fertility norm among women was associated with greater likelihood of pregnancy intention [RRR = 2.35 (95% CI: 1.25,4.39); ARRR = 1.53 (95% CI: 0.70,3.30)], lower likelihood of delaying pregnancy [RRR = 0.69 (95% CI: 0.50,0.96); ARRR = 0.72 (95% CI: 0.51,1.02)] and greater ambivalence on delaying pregnancy [RRR = 1.92 (95% CI: 1.18,3.14); ARRR = 1.99 (95% CI: 1.21,3.28)]. Women's higher FNS scores were also associated with higher sterilization [RRR = 2.17 (95% CI: 1.28,3.66); ARRR = 2.24 (95% CI: 1.32,3.83)], but the reverse was noted for men [RRR = 0.61 (95% CI: 0.36,1.04); ARRR = 0.54 (95% CI: 0.32,0.94)]. FNS indicated better predictive value among women compared to men for key reproductive outcomes. This measure may be useful for social norms-focused evaluations in family planning and warrants cross-contextual study.

中文翻译：

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印度生育标准量表的验证及其与生育意愿和避孕药具使用的关联


与生育相关的社会规范可能会推动怀孕意愿、时机和避孕药具的使用，但测量却滞后。我们在印度 1021 名女性和 1020 名男性中验证了包含 10 项的强制生育标准量表 (FNS)，并研究了其与计划生育结果的关系。 FNS 捕捉到了人们对生育、早婚和社区压力的期望。我们分别通过 Cronbach α 和探索性因子分析 (EFA) 评估可靠性和结构有效性，检查与生育意愿和避孕药具使用的关联。 FNS 表现出良好的可靠性 (α = 0.65–0.71) 和按性别划分的不同子结构。女性的高生育能力与更大的怀孕意愿相关[RRR = 2.35 (95% CI: 1.25,4.39)； ARRR = 1.53 (95% CI: 0.70,3.30)]，延迟妊娠的可能性较低[RRR = 0.69 (95% CI: 0.50,0.96)； ARRR = 0.72 (95% CI: 0.51,1.02)]并且对延迟妊娠更加矛盾[RRR = 1.92 (95% CI: 1.18,3.14)； ARRR = 1.99 (95% CI: 1.21,3.28)]。女性较高的 FNS 评分也与较高的绝育率相关 [RRR = 2.17 (95% CI: 1.28,3.66)； ARRR = 2.24 (95% CI: 1.32,3.83)]，但男性则相反 [RRR = 0.61 (95% CI: 0.36,1.04)； ARRR = 0.54（95% CI：0.32，0.94）]。 FNS 表明，与男性相比，女性对关键生殖结局的预测价值更高。这项措施可能有助于计划生育中以社会规范为中心的评估，并值得进行跨背景研究。